Active NPI
Paulina Trujillo Perez
- Marriage & Family Therapist
- Montclair, CA
National Provider Identifier
1689982498
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Marriage & Family Therapist
- Practice address
- 9916 Central Ave.
Montclair, CA 91763 - Phone
- (909) 450-2502
- Fax
- (909) 450-0237
- NPI assigned
- Sep 15, 2010
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Mental Health Counselor | 101YM0800X | |||
| Marriage & Family Therapist | 106H00000X | Primary |
Addresses
Primary practice location
9916 Central Ave.
Montclair, CA 91763
Mailing address
9916 Central Ave.
Montclair, CA 91763
Phone (909) 450-2502
Other practice location 1
1333 Iris Ave
Boulder, CO 80304-2226
Phone (303) 413-6212
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Opted out of Medicare
- Yes, effective Jan 1, 2024 through Jan 1, 2028
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1284508800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1564963200000",
"number": "1689982498",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "9916 CENTRAL AVE.",
"city": "MONTCLAIR",
"state": "CA",
"postal_code": "91763",
"telephone_number": "909-450-2502",
"fax_number": "909-450-0237"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "9916 CENTRAL AVE.",
"city": "MONTCLAIR",
"state": "CA",
"postal_code": "91763",
"telephone_number": "909-450-2502",
"fax_number": "909-450-0237"
}
],
"practiceLocations": [
{
"address_1": "1333 Iris Ave",
"address_purpose": "LOCATION",
"city": "Boulder",
"state": "CO",
"postal_code": "803042226",
"country_code": "US",
"telephone_number": "303-413-6212",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "TRUJILLO PEREZ",
"first_name": "PAULINA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2010-09-15",
"last_updated": "2019-08-05",
"status": "A"
},
"taxonomies": [
{
"code": "101YM0800X",
"taxonomy_group": "",
"desc": "Counselor, Mental Health",
"state": null,
"license": null,
"primary": false
},
{
"code": "106H00000X",
"taxonomy_group": "",
"desc": "Marriage & Family Therapist",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Montclair, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 5, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Opt Out Affidavits.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.